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Extensão do comprometimento axilar após biópsia de linfonodo sentinela positivo nas pacientes com câncer de mama operadas no Hospital de Clínicas de Porto AlegreFontana, Vivian January 2017 (has links)
Introdução: o status dos linfonodos axilares permanece um dos mais importantes fatores prognósticos no carcinoma de mama em estágios iniciais, além de definir o uso de terapias complementares. A biópsia de linfonodo sentinela (BLNS) surgiu com a finalidade de estadiar a axila com o mínimo de morbidade, tendo como objetivo a identificação e o estudo patológico do primeiro linfonodo axilar proveniente da drenagem linfática da mama. Pacientes com axila clinicamente negativa têm indicação de biópsia de linfonodo sentinela como método de estadiamento da axila, e quando o resultado era positivo para metástase recomendava-se o esvaziamento axilar. Por recomendação do ACOSOG Z0011, o esvaziamento axilar (EA) após uma biópsia de linfonodo sentinela positivo não é necessário. Esse estudo demonstrou não haver benefício em realizar o EA na presença de LNS positivo na sobrevida global ou na sobrevida livre de doença. Objetivos: Avaliar a taxa de recidiva e morte em pacientes submetidas à cirurgia conservadora de mama e BLNS positiva com posterior esvaziamento axilar no Hospital de Clínicas de Porto Alegre; e, como objetivo secundário, avaliar as características clínicas e patológicas dessa população. Método: foi realizado um estudo de coorte retrospectiva, incluindo pacientes com diagnóstico de carcinoma de mama invasor submetidas à cirurgia conservadora da mama e BLNS, cujo resultado foi positivo para presença de metástases, e foram submetidas ao EA o período de janeiro de 2004 a dezembro de 2008. Resultados: foram incluídas 144 pacientes submetidas à biópsia de linfonodo sentinela e CCM; 33 tiveram o achado de biópsia de linfonodo sentinela positivo para metástase, e dessas 33 pacientes restaram 27 para análise dos dados. A taxa de sucesso na identificação do LNS foi de 0,96. A idade média das pacientes foi de 53,8 anos, o número de LNS ressecados foi de 1,6 por paciente; a média do tamanho tumoral foi de 2,3 cm. Seis pacientes apresentaram doença axilar residual correspondendo a 22,2% da amostra e tiveram um risco relativo de morte de 3 vezes mais para aquelas sem doença axilar residual e 50% a mais de desenvolvimento de metástases. Conclusão: O comprometimento axilar é importante fator no prognóstico das pacientes com câncer de mama, quanto maior o comprometimento da axilar pior será o desfecho de sobrevida livre de doença e de morte. Acreditamos que se pode aplicar a conduta do ACOSOG Z0011 também nas pacientes do HCPA devido à alta sensibilidade do método no nosso meio. / Introduction: The status of axillary lymph nodes remains one of the most important prognostic factors in breast carcinoma in the early stages, in addition it helps to defining the use of complementary therapies. Sentinel lymph node biopsy (SLNB) was developed with the purpose of staging the axilla with minimal morbidity, aiming at the identification and pathological study of the first axillary lymph node from the lymphatic drainage of the breast. Patients with clinically negative lymph node have indication of SLNB as a method of axillary staging, and with a positive finde for metastasis the axilar clereance was performed. Nowadays, due to the ACOSOG Z0011 Study, the axillary dissection (AD) after a positive SLNB for metastasis was put in check. This estudy have as a result no difference in global survive ou disease free survive if ALND was not performed in a positive SLNB. In the present study, we intend to evaluate the clinical and histopathological characteristics of patients submitted to breast conservative surgery and sentinel lymph node biopsy with a positive result for metastasis. Main objective: Evaluate the rate of recurrence and death in patients submitted to conservative breast surgery and BLNS with posterior axillary emptying at Hospital de Clínicas, Porto Alegre. It is a secondary objective to evaluate the clinical and pathological characteristics of this population. Material and Methods: A retrospective cohort study was performed, including 144 patients diagnosed with invasive breast carcinoma submitted to conservative breast surgery and SLNB, whose results were positive for metastases, and were submitted to AD, at the Mastology Unit of the Hospital de Clinicas de Porto Alegre (HCPA), from January 2004 to December 2008. Results: Of 144 patients submitted to SLNB and BCS, 33 had SLNB positive for metastasis, of these 33 patients remained 27 for data analysis. The success rate in LNS identification was 0.96. The mean age of the patients was 53.8 years, the number of resected SLN was 1.6 per patient; The mean tumor size was 2.3 cm. Six patients had residual axillary disease corresponding to 22.2% of the sample and had a relative risk of death of 3 times more for those without residual axillary disease and 50% more for the development of metastases. Conclusion: Axillary involvement is an important factor in the prognosis of patients with breast cancer, and the greater the axillary impairment, the worse the diseasefree survival outcome and death. We believe that the ACOSOG Z0011 trial can also be applied to HCPA patients who meet the inclusion criteria for this purpose, due to the high sensitivity of the method in our environment.
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Transição epitélio-mesenquimal e presença de células CD44+/CD24- como fatores de predição de metástase axilar no câncer de mama inicial / Epithelial-mesenchymal transition and the CD44+/CD24- cells as predicting factors for lymph node metastasis in early breast cancerFernando Antonio Mourão Valejo 20 September 2010 (has links)
Sabemos hoje que os tumores sólidos apresentam uma composição celular heterogênia e que apenas uma pequena parcela dessas células apresenta capacidade de se proliferar e gerar novos tumores. Estudos prévios sobre a formação do câncer de mama têm sido realizados com base na combinação dos marcadores de superfície celular CD44 e CD24. Já foi demonstrado que uma subpopulação de células do câncer de mama com alta expressão de CD44 e baixa expressão de CD24 (CD44+/CD24-) tem maior capacidade de gerar tumores, quando comparadas com a subpopulação de células CD44-/CD24+. O objetivo do estudo foi identificar a taxa de células com fenótipo CD44+/CD24- presentes nos tumores mamários e relaciona-la com a taxa de comprometimento dos linfonodos axilares ipsilaterais por neoplasia, além de avaliar também sua relação com outros fatores sabidamente relacionados com mal prognóstico da paciente. Pacientes e métodos: avaliamos prospectivamente 53 amostras cirúrgicas provenientes de 42 pacientes com diagnóstico histopatológico de carcinoma de mama, quantificando as células CD44+/CD24- por citometria de fluxo. Relacionamos a porcentagem destas células encontrada em cada amostra com o comprometimento axilar, os receptores hormonais e Her-2, a idade da paciente, o grau histológico do tumor, o diâmetro patológico do tumor e o tipo histológico. Resultados: verificamos um significante aumento da população de células CD44+/CD24- no grupo de carcinomas ductais invasivos em pacientes que apresentavam metástase axilar [mediana 8,53% (3,6 71,2%)] em relação ao grupo de pacientes sem linfonodos comprometidos pela neoplasia [mediana 1,49% (0,3 17,1%)] (p=0,0002). Conclusão: concluímos então que quando estudamos vários tumores mamários invasivos de mesma classificação histológica, podemos notar que existe uma variação na quantidade de células CD44+/CD24- entre eles. Nosso estudo mostrou que essa variação está relacionada à agressividade tumoral e à sua capacidade de gerar metástases já que, tumores com maior quantidade de células CD44+/CD24- apresentam maior taxa de comprometimento dos linfonodos axilares. / It is known that solid tumors are composed by a heterogeneous combination of cells and only a small portion of these cells has the capacity to proliferate and generate new tumors. Previous studies about the breast cancer initiation have been based on a combination of CD44 and CD24cell surface markers. It has been shown that this subpopulation of breast cancer cells with high expression of CD44 and low expression of CD24 (CD44+/CD24-) has a greater capacity to generate tumors when compared with the subpopulation of cells CD44- /CD24+. The study objective was to identify whether the rate of cells with CD44+/CD24- phenotype present in breast tumors is related with the rate of ipsilateral lymph node metastasis, in addition to evaluate its relationship with other risk factors known to be related with worst prognosis. Patients and methods: we prospectively evaluated 53 surgical specimens from 42 patients with histological diagnosis of breast cancer, quantifying CD44+/CD24- cells through flow cytometry. We list the percentage of these cells found in each sample with axillary lymph node status, hormone receptors and Her-2, patient age, histological grade, pathological tumor diameter and histological tumorclassification. Results: we find a significant increase of CD44+/CD24- population in the invasive ductal carcinomas, in patients with axillary metastasis [median 8.53% (3.6 - 71.2%)] than in the group of patients without lymph nodes metastasis [median 1.49% (0.3 - 17.1%)] (p = 0.0002). Conclusion: when we studied several invasive breast tumors of same histological classification, we note that there is variation in the number of CD44+/CD24- cells. Our study showed that this variation is related to tumor aggressiveness and their ability to generate metastasis, because tumors with high rate of CD44+/CD24- cells have a higher rate of lymph node metastasis.
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Mechanism of Vein Pattern Formation in Arabidopsis Thaliana Leaves: testing the Canalization HypothesisAmin, Mira January 2011 (has links)
Several mechanisms have been proposed to explain the process of vein pattern formation in plant tissues. The most widely accepted amongst biologists is the canalization hypothesis, derived from pea root and stem experiments. According to this hypothesis, a signal, thought to be the phytohormone auxin, is transported polarly from cell to cell from the shoot to the root and is canalized progressively into narrow channels of high auxin fluxes that later differentiate to become vascular tissue.
In this project, we set out to test whether auxin canalization drives vein pattern formation, using Arabidopsis thaliana mutants with increased auxin transport (max4-1, max3-9, max2-1 and max1-1). We predicted that the mutants would have distinct vein patterns and especially different angles between the primary and secondary veins, compared to the wild type. First rosette leaves of 15 plants per genotype were harvested for analysis each day from 7 to 17 days after sowing, giving a total of eight hundred twenty-five leaf samples to analyze. Venation patterns were extracted and analyzed using custom-made software written with Matlab.
Overall, compared with the wild type, mutants with the highest auxin transport (max4-1 and max3-9) had different vein patterns at early developmental stages, confirming a role for auxin transport in vein patterning. However, veins of mutants and wild type connected at similar angles, which is not consistent with the auxin canalization hypothesis, as originally formulated.
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Diversity in Tiller Suppression of Domesticated Cereals: MorphologicalVariance Observed in Maize, Sorghum, and SetariaLongstaff, Muriel Tahiameiani 01 June 2018 (has links)
Tillers are vegetative branches found in grasses, which develop in early stages of plant life. Located at the base of the central stalk, tillers have agronomical importance by increasing seed production with fewer tillers, or providing alternative forms of biofuel with more tillers. As grains have typically decreased tiller number while undergoing domestication, we explored wild and domesticated strains of varying grains by doing a morphological analysis on tiller development. This thesis shows how the decrease of tillers through in domestication cereals shows diversity not only across maize, Sorghum, and Setaria, but also between lines of maize and Setaria species. To do so, we first measured axillary bud growth across these grasses and compared bud initiation, growth, dormancy and outgrowth. While maize inbred B73 demonstrated a tiller dormancy pattern by initiating buds, growing buds and then bud dormancy we measured growth in Sorghum and Setaria to compare and found that although Sorghum patterns dormancy similar to maize, Setaria had more than one way tiller suppression not previously expected. We look further at Setaria buds with a statistical analysis of tiller origin and bud frequency in a wild strain and two domesticated strains of Setaria. Furthermore we performed Scanning Electron Microscopy (SEM) to have a clear understanding of bud initiation or lack of initiation in Setaria italica (B100) comparing it to its wild ancestor Setaria viridis. Because of the diversity in Setaria, we re-visited maize tiller domestication by taking bud measurements, performing SEMs and counting bud frequency on other strains of inbred maize. We found that maize also shows diversity in its patterning of tiller domestication. These results demonstrate that there is diversity in the patterns in which tiller domestication has occurred. This diversity is shown here through differences in tiller bud decisions to initiate or not initiate, or to have axillary buds go dormant post-initiation. Furthermore this variance is shown through differences in bud frequency counts, growth measurements, SEMs, and where tiller branches originate across the grains of maize, Sorghum and Setaria.
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Effect of number of axillary buds on stem cuttings of sweet potato (pomoea batatas) CV. 'Blesbok' productivity using sack gardening technologyMoitsi, Lebogang Rejoice January 2022 (has links)
Thesis (M.Sc. (Horticulture)) --University of Limpopo, 2022 / Worldwide, water scarcity, land degradation and unavailability of agricultural lands have
posed serious threats on food security and income generation. Hunger, micronutrient
deficiencies and starvation are likely to go up in Africa due to increasing urbanisation
and rise in global food prices. As a result, it is important to identify innovative vegetable
growing-based strategies, which can increase access to food by utilising the limited
space available in rural and urban areas. Therefore, sack gardening technology could
be a solution to both the lack of arable land and water scarcity in urban and rural areas.
The objective of the study was to determine whether axillary bud number will have an
effect on agronomic parameters and yield of sweet potato cv. 'Blesbok' produced using
the sack gardening technology. Treatments, namely, 1, 2, 3, 4, and 5 number of axillary
buds per stem cutting, were arranged in randomised complete block design, with 10
replicates. One bud (1) was used as a control. Different stem cuttings measuring from
10 to 30 cm long with approximately one (1) to six (6) axillary buds were collected from
mature sweet potato plantation at a certified nursery from cv. 'Blesbok'. A total of eight
(8) stem cuttings were planted in sacks consisting of growing media mixture of steam
pasteurised loam soil and compost (3:1 v/v), 4 on top side of the sack and the
remaining four on the side-holes of the sack. Insect pests were scouted and monitored
weekly, while diseases were managed using spraying programmes as in commercial
sweet potato production systems. Two weeks after transplanting, each plant was
fertilised with 5 g nitrogen (N), phosphorus (P), and potassium (K) 2:3:2 (26) + 0.5%
Zinc (Zn) + 5% sulphur (S) and 5% calcium (Ca). Number of axillary buds had
significant effects on vine length, fresh shoot mass, number of shoots and dry shoot
mass contributing 59%, 58%, 45% and 58% in total treatment variation (TTV),
respectively, whereas axillary bud numbers had no significant effects on fresh tuberous
root mass, chlorophyll content, vine stem diameter, tuberous root diameter, tuberous
root length, dry tuberous root mass and number of tuberous roots. Relative to control
(one bud), two (2), three (3), four (4), five (5) number of axillary buds decreased vine
length, fresh shoot mass and dry shoot mass by 8-37, 30-55 and 26-55%, respectively.
However, relative to control (one bud), number of axillary buds increased number of
shoots by 8-17%. The quadratic relationship models were explained by 95, 92, 96 and
98% of vine length (VL), number of shoots (NS), fresh shoot mass (FSM) and dry shoot
mass (DSM), respectively. In conclusion, findings of the study demonstrated that a
single (1) or two (2) axillary bud(s) on stem cuttings of sweet potato CV. „Blesbok‟
showed better results for both yield and growth parameters as compared to three (3),
four (4) and five (5) buds. / AgriSETA
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Determination of Activity Deposited in the Axillary Lymph Nodes by Direct, In vivo Radiation MeasurementsLobaugh, Megan L. January 2013 (has links)
No description available.
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Expressão imunohistoquímica do fator indutor de hipóxia 1-alfa (HIF-1?) em pacientes com câncer de mama localmente avançado / Immunohistochemical expression of hypoxia-inducible factor 1-alpha in locally advanced breast cancer patientsBrito, Luiz Gustavo Oliveira 15 July 2010 (has links)
Objetivos: Determinar a expressão imunohistoquímica do fator indutor de hipóxia 1-alfa (HIF-1-alfa) e suas variáveis associadas em pacientes com câncer de mama localmente avançado. Pacientes e método: Vinte e sete mulheres foram biopsiadas para diagnóstico histopatológico do carcinoma mamário e submetidas a tratamento quimioterápico pré-cirúrgico. Analisou-se a associação do HIF-1-alfa com idade, tamanho tumoral, grau histológico, estadio clínico, status hormonal e axilar, resposta clínica e patológica após tratamento quimioterápico, expressão do receptor de estrogênio, progesterona e cerbB2. Resultados: A expressão de HIF-1-alfa foi presente em 66,7% das pacientes. O único fator associado à sua presença foi o status axilar positivo (p=0,02), tendo permanecido durante a análise univariada. As demais variáveis não apresentaram associação estatisticamente significante. Conclusão: Existe uma associação estatisticamente significante entre o acometimento linfonodal e a presença de HIF-1-alfa em pacientes com câncer de mama localmente avançado. / Objectives: To assess the expression of HIF-1 and its associated variables with locally advanced breast cancer (LABC) patients. Methods: Twenty-seven women were submitted to incisional biopsy for histopathological diagnosis of breast carcinoma and undertaken to neoadjuvant chemotherapy (NACT). It was studied the association of HIF-1 with age, tumoral size, histological grade, clinical stage, hormonal and axillary status, clinical and pathological response after NACT, expression of estrogen and progesterone receptors, as well as the presence of cerbB2 antigen. Results: HIF-1-alpha expression was found in 66.7% of patients. Only axillary status was the associated factor with its presence (p=0.02), and remained after univariate analysis. The others did not present any significant statistically difference. Conclusion: There is a significant statistically association between axillary status and HIF-1-alpha expression in LABC patients.
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Linfonodo sentinela e dissecção axilar: análise da disfunção de membros superiores / Axillary and sentinel lymph node dissection: analysis of the dysfunction of the upper limbsAntonio, Heriton Marcelo Ribeiro 05 September 2011 (has links)
O câncer de mama é a neoplasia maligna que mais acomete as mulheres na população brasileira. Atualmente o tratamento para o câncer de mama está fundamentado em três pilares: radioterapia, cirurgia em suas diversas técnicas, quimioterapia/hormonioterapia. A qualidade de vida pode ser afetada de uma forma geral, envolvendo os aspectos físicos, psicológicos, sociológicos, emocionais, entre outros. O objetivo deste estudo foi comparar a função do membro superior em pacientes com câncer de mama que foram submetidas à biópsia de linfonodo sentinela com as submetidas à dissecção axilar, e que não foram acompanhadas por um protocolo de reabilitação pré-estabelecido. Pacientes e métodos: foram avaliadas 36 pacientes que passaram por dissecção axilar (grupo DA), 29 que foram submetidas à biópsia de linfonodo sentinela (grupo BLS) e 11 sujeitos normais (grupo SN). Resultados: Verificamos que o grupo DA apresenta um risco de ter perda funcional para os movimentos de flexão e abdução de ombro na ordem de 5 e 3,7 vezes maior que o grupo BLS, respectivamente. Encontramos também que pacientes submetidas à BLS evoluem com disfunção significativa para a flexão e abdução de ombro quando não submetidas à intervenção fisioterápica. Conclusão: A DA apresenta uma maior disfunção em membro superior quando comparada com BLS. A reabilitação de pacientes submetidas à BLS não pode ser ignorada, pois esta intervenção cirúrgica pode levar a disfunção significativa do membro superior ipsilateral / Breast cancer is a malignancy that affects more women in the Brazilian population. Currently the treatment for breast cancer is based on three pillars: radiotherapy, surgery in its various techniques, chemotherapy / hormone therapy. Quality of life may be affected in general, involving the physical, psychological, sociological, emotional, and others. The aim of this study was to compare the upper limb function in patients with breast cancer who underwent sentinel lymph node biopsy with axillary dissection underwent, and were not accompanied by a rehabilitation protocol pre-established. Patients and methods: we evaluated 36 patients who underwent axillary dissection (group DA), 29 who underwent sentinel lymph node biopsy (SNB group) and 11 normal subjects (group SN). Results: We found that the DA group presents a risk of loss of function for flexion and shoulder abduction in the order of 5 and 3.7 times higher than the BLS group, respectively. We also found that patients who underwent SNB evolve with significant dysfunction for flexion and shoulder abduction when not undergoing physiotherapy intervention. Conclusion: The DA has a higher dysfunction in upper limb when compared with BLS. The rehabilitation of patients who underwent SNB can not be ignored because this surgery can lead to significant dysfunction of the ipsilateral upper limb
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Sympathikusaktivität bei handchirurgischen Operationen mit axillärer Plexus- oder Allgemeinanästhesie / Activity of the sympathetic nervous system of patients undergoing hand surgery under axillary plexus blockade (axPlex) or general anesthesia (ITN)Klaholz, Andreas Manfred 12 February 2014 (has links)
Ziel dieser Studie war die Messung der Symphatikusaktivität als Indikator einer Stressreaktion bei handchirurgischen Eingriffen. Zwei Gruppen á 23 Patienten (Alter [Jahre] ITN 21-76(51) axPlex 27-66(52) p=0,73; BMI ITN 18,2-40,3(26,4) axPlex 20,9-34,9(25,5) p=0,97), die sich in ultraschallgesteuerter axillärer Plexusblockade (axPlex) oder Allgemeinanästhesie (ITN) einer Operation unterziehen mussten, wurden nach Genehmigung durch die Ethikkommission untersucht. Ausschlusskriterien waren ein Alter < 18 Jahre oder > 80 Jahre, eine ASA-Klassifikation > III, sowie eine Kontraindikation gegen die verwendeten Medikamente oder Narkosenformen. Die Symphatikusaktivität wurde anhand des Hautwiderstands (ESG® 1001, Ingenieurbüro Dr.Janitzki, Altenbeken, Germany) gemessen. Die Herzfrequenz (HF), der non invasive Blutdruck und die Hauttemperatur wurden erfasst. Die Messung umfasste sieben Zeitpunkte (T-Ausgangswert, T-Narkosebeginn, T-Blutsperre, T-Schnitt, T-OP-Ende, T-Aufwachraum, T-Normalstation). Die Narkosetiefe der ITN wurde mit BIS® (40-60) überwacht. Die Analyse zeigte signifikante Unterschiede zwischen beiden Gruppen. In Bezug auf die Sympathikusaktivität konnte kein Unterschied zwischen beiden Gruppen gefunden werden.
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Strategies in aboveground space occupancy in herbs from disturbed habitats / Strategies in aboveground space occupancy in herbs from disturbed habitatsBARTUŠKOVÁ, Alena January 2012 (has links)
Disturbance is an important phenomenon affecting plant lives and shaping plant strategies in disturbed habitats. A variety of ecological concepts on individual plant response to injury has been proposed for specific natural ecosystems or growth forms. In central Europe, man-made habitats are often cases of disturbed places, so the aim of the thesis was to apply four chosen concepts on them. The thesis is composed of four original studies performed in two model ecosystems: recurrently disturbed ruderal place and regularly mown central European meadow. The occupying of the aboveground space after a disturbance event was studied here either as renovation of biomass or architecture. Regenerative strategies in herbs occupying disturbed habitats were described and confronted with concepts proposed originally for ecosystems subjected to natural disturbance regimes.
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